RESUMO
Type 2 diabetes mellitus and diabetic nephrophathy considered to be an inflammatory process in which immune cells involved in its development and progression apart from traditional metabolic and hemodynamic risk factors. This study was designed to determine the balance between T helper 17 and regulatory T cells in Type 2 diabetic patients having diabetic nephropathy in relation to type 2 diabetic patients without renal involvement and healthy individuals. This study included 3 groups; diabetic2 nephrophathy patients [on basis of proteinuria and reduced GFR], diabetic patients [ADA, 2015] and healthy controls of the same age and sex Detection of T regs and Th 17 cell were evaluated; T regs expressing CD4 and CD 25 while Th 17 cells expressing CD4 and CD161 was done by standard 2-color flow cytometry and Th17/Treg cells ratio was calculated. The results revealed that there was higher mean Th17 and Th17/Treg cells ratio among type 2 diabetic nephropathy patients compared to other two groups. There was lower mean Treg cells among type 2 diabetic nephropathy patients compared to other two groups with very high statistically significant differences. Also, there was higher mean Th17 and Th17/Treg cells ratio among type 2 diabetic patients compared to healthy individuals with very statistically significant differences that there was a strong positive correlation between BUN, serum creatinine, proteinuria and the grade of nephrropathic affection by the ultrasound from one side and Th17 and Th17/T reg cells ratio on the other side. But this correlation was strongly negative with T reg cells
RESUMO
Background: Chronic Spontaneous Urticaria [CSU] is an allergic auto-immune disease with more than 6 weeks of continuous symptoms, it is known to trigger allergic wheal formations and angioedema. Vitamin D at optimal levels plays an important role in adjusting innate immunity thus People who has deficient or insufficient levels of serum vitamin D suffer from disturbance in immune system. Accordingly, studies have been established to explore the effect of vitamin D on CSU. Aim of the Study: To determine the effect of 12 weeks daily oral vitamin D supplementation [ high [4,000 IU/d] versus low [600 IU/d] dose of orally administered vitamin D3] on Urticaria activity score [UAS-7], quality of life [QOL] and medication burden in patients with chronic spontaneous urticaria, and to assess the relationship between vitamin D levels and CRP in these patients
Patients and methods: This single blind randomized prospective study conducted to 50 patients with CSU, admitted to Ain shams hospital, 50 patients were divided into 2 groups according to the dose of vitamin D orally administrated to these subjects, the first was group A , patients have received vitamin D orally in High dose 4000 IU/Day compared to group B , which included 25 cases received oral vitamin D in a low dose concentration 600 IU/d , Patients has been followed up in 3 times at baseline [0 week] , 6 weeks and 12 weeks intervals
Results: Serum vitamin D levels in Group were higher than Group B [44.48 12.86 vs 34.45 5.43]. Medication consumption was higher in group A compared to group B, thus favors orally low dose administration of vitamin D at first 6 weeks in the beginning of treatment course. UAS7 score in group A was better than Group B from baseline]to 6 weeks [P=0.009 vs 0.239] and from 6 weeks to 12 weeks. [P= 0.011 vs<0.0011]. There was no significant difference in serum CRP between group A and group B as regards to CRP,furthermore there was no statistically correlation between 3 times intervals in group A and group B separately [12.71 1.47 vs 13.11 1.45]
Conclusion: Improvement of both quality of life, and UAS7 score after receiving of High dose 4000 IU/d vitamin D orally in Group A, could benefit patients with CSU and decrease the complication of this disease. It was also found Serum Vitamin D level has no significant relation with C Reactive protein level, thus we couldn't relay on evaluation the chronicity of urticarial by measuring its value in serum blood with patients suffering from chronic spontaneous idiopathic urticaria